Floyd County Dentist Pleads Guilty to Health Care Fraud
Article Type
Investigative Press Release
Publish Date
Logo
Website
Abbreviation
HHSOIG
Agencies
Department of Health & Human Services
Federal Agency
Yes
Location
United States
What to Report to the OIG Hotline
The U.S. Department of Health and Human Services (HHS) Office of Inspector General's (OIG) mission is to protect the integrity of HHS programs as well as the health and welfare of program beneficiaries. In doing so, we rely on complaints by HHS employees, contractors, subcontractors, grantees and subgrantees (i.e. whistleblowers) who report fraud, waste, abuse or mismanagement in HHS programs. We also review and investigate reports of whistleblower retaliation.
If you would like more information on what kinds of complaints our OIG investigates, please visit our website at https://oig.hhs.gov/fraud/report-fraud/before-you-submit.asp. There you will find a list of things you should know before submitting a complaint to the OIG.
If you would like more information on the types of whistleblowers protected by the OIG, please visit our whistleblower protection page at https://oig.hhs.gov/fraud/report-fraud/whistleblower.asp.
If you are a whistleblower and wish to report fraud, waste, abuse or mismanagement in HHS programs, or you wish to report whistleblower retaliation, please visit our Hotline at https://oig.hhs.gov/fraud/report-fraud/index.asp.
What Not to Report to the OIG Hotline
- Issues about Medicare policy, coverage, billing claims or appeals
- Lost or stolen Medicare card
- Allegations by HHS employees of discrimination on the basis of race, gender, ethnicity, religion or sexual preference
- Allegations by employees or applicants concerning prohibited personnel practices; or Hatch Act violations
- Appeals of administrative decisions made by HHS agencies, grantees or contractors, including Medicare payment decisions and contract or grant awards
- Appeals of judicial decisions by federal or state courts involving HHS programs
- Complaints of failure to safeguard medical information, i.e. HIPAA violations
- Customer service complaints involving HHS employees, grantees or contractors
- Allegations of identity theft unrelated to HHS programs
- Disability fraud
- SNAP/Food Stamp Fraud
- Self-Disclosures
Hotline Page
Whistleblower Protection Page
Pain doctor pays to settle allegations of deceptive Medicare billing
Article Type
Investigative Press Release
Publish Date
CMS's Encounter Data Lack Essential Information That Medicare Advantage Organizations Have the Ability to Collect
2020
OEI-03-19-00430
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services
National Provider Identifiers (NPIs) for physicians and nonphysician practitioners who order and/or refer services (ordering providers) are essential for safeguarding the program integrity of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS); clinical laboratory services...
Indiana Properly Reported Adjustments Related to the Drug Rebate Program
2020
A-05-19-00028
Audit
Department of Health & Human Services OIG
Department of Health & Human Services
On the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (Form CMS-64) for the quarter ended September 30, 2014, Indiana claimed increasing adjustments on Line 10A, Adjustments Decreasing Claims For Prior Quarters: Federal Audit (Line 10A). We audited Indiana's...
Rhode Island's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 18 of 30 Providers Reviewed
2020
A-01-18-02505
Audit
Department of Health & Human Services OIG
Department of Health & Human Services
The Child Care and Development Block Grant Act (CCDBG Act) of 2014 added new requirements for States that received funding from the Child Care and Development Fund (CCDF) to conduct comprehensive criminal background checks on staff members and prospective staff members of child care providers every...
New Jersey Did Not Ensure That Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries Residing in Nursing Facilities Were Always Properly Investigated and Reported
2020
A-02-18-01006
Audit
Department of Health & Human Services OIG
Department of Health & Human Services
This audit report is one of a series of OIG reports that addresses the identification, reporting, and investigation of incidents of potential abuse and neglect of our Nation's most vulnerable populations, including Medicaid beneficiaries in nursing facilities.Nursing facility residents are at...
Nebraska Claimed Unallowable School-Based Administrative Costs Because of Improper Coding of Random Moment Timestudy Responses
2020
A-07-19-03234
Audit
Department of Health & Human Services OIG
Department of Health & Human Services
Prior Office of Inspector General audits of State Medicaid agencies that used random moment timestudies (RMTSs) to allocate costs for school-based administrative (SBA) costs determined that States did not always correctly claim Federal Medicaid reimbursement for SBA services. Nebraska, whose SBA...
Medicare Home Health Agency Provider Compliance Audit: Mission Home Health of San Diego, Inc.
2020
A-09-18-03008
Audit
Department of Health & Human Services OIG
Department of Health & Human Services
Under the Medicare home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide...
Opioid Use in Medicare Part D Continued To Decline in 2019, but Vigilance Is Needed as COVID-19 Raises New Concerns
2020
OEI-02-20-00320
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services
The United States has been grappling with the opioid crisis for several years. In 2018, nearly 47,000 opioid-related overdose deaths occurred in the United States. OIG has been tracking opioid use in Medicare Part D since 2016. In particular, OIG has identified beneficiaries at serious risk of...
Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2018 Average Sales Prices.
2020
OEI-03-20-00130
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services
When Congress established average sales prices (ASPs) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts. Generally, Part B-covered drugs are those that are injected or infused in...